Provider Demographics
NPI:1871647586
Name:ZHAO, WU (LAC)
Entity Type:Individual
Prefix:DR
First Name:WU
Middle Name:
Last Name:ZHAO
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1871 MARTIN AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:SANTA CLARA
Mailing Address - State:CA
Mailing Address - Zip Code:95050-2501
Mailing Address - Country:US
Mailing Address - Phone:408-988-8581
Mailing Address - Fax:408-988-8734
Practice Address - Street 1:1871 MARTIN AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95050-2501
Practice Address - Country:US
Practice Address - Phone:408-988-8581
Practice Address - Fax:408-988-8734
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2008-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC8600171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist